AB0173 MORPHOLOGICAL PARAMETERS ASSESSED BY ULTRASOUND IN QUADRICEPS MUSCLE WERE ASSOCIATED WITH CLINICAL FEATURES, MUSCLE STRENGTH, FUNCTIONAL CAPACITY AND PHYSICAL FUNCTION OF RHEUMATOID ARTHRITIS PATIENTS
Authors: L. Santos, R. Cavalheiro Do Espírito Santo, É. Pena, L. Denardi Dória, S. Pilotti, D. Nóbrega de Moraes, M. Marchezan Menezes Da Silva, V. Hax, C. Brenol, O. Monticielo, R. Mendonça Da Silva Chakr, R. Xavier
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) patients usually present extra-articular manifestations (1,2), which affect muscle mass and, consequently, physical function (3). Among the various methods to assess muscle mass we tested muscle morphology by ultrasound (MU) to verify the associations of the quadriceps muscle with clinical features, muscle strength, functional capacity and physical function. Objectives To assess the MU of the quadriceps muscle and verify the muscle quality assessed by the pennation angle and its associations with clinical features, muscle strength, functional capacity and physical function in RA patients. Methods RA women, age ≥18years and who met 2010 American College of Rheumatology (ACR) criteria were included. Morphological parameters in quadriceps muscle consisted of the pennation angle of rectus femoris (RF), vastus intermedius (VI) and vastus lateralis (VL). RA activity was measured by 28-joint disease activity score (DAS28), muscle strength by handgrip and chair stand tests, functional capacity by health assessment questionnaire (HAQ), and physical function by timed-up-and-go (TUG) test and short physical performance battery (SPPB). Pearson’s or Spearman’s correlation coefficients were explored. The significance level was set at p ≤ 0.05 for all analyzes. Results Eighty-one patients were included (age: 58.64±9.52 years old; DAS28: 3.24±1.34). Smaller pennation angle in rectus femoris (RF) were associated with lower handgrip strength (r= 0.224, p=0.044), chair stand test (r= -0.372, p=0.004), HAQ (r= -0.404, p=0.001), SPPB (r= 0.262, p=0.047), as well as higher disease activity by DAS-28 (r= -0.415, p&lt;0.0001) and age (r= -0.290, p=0.009). Smaller pennation angle in vastus intermedius (VI) were associated with worse chair stand (r= -0.281, p=0.033), HAQ (r= -0.302, p=0.015) and higher disease activity by DAS-28 (r= -0.304, p=0.006). Lastly, smaller pennation angle in vastus lateralis (VL) were associated with worse chair stand (r= -0.290, p=0.027), as well as higher DAS-28 (r= -0.237, p=0.033) and age (r= -0.272, p=0.014). Conclusion The pennation angles of the quadriceps muscle evaluated by ultrasound (RF, VI and VL muscles) were associated with chair stand test and DAS-28. In addition, the level of disease activity assessed by DAS-28 also appears to be affecting the quadriceps muscle. Finally, MU may be a useful method to evaluate the impact of the disease on skeletal muscle. References [1]Summers GD, Deighton CM, Rennie MJ, Booth AH. Rheumatoid cachexia : a clinical perspective. 2008;(April):1124–31. [2]da Rocha OM, Batista A de AP, Maestá N, Burini RC, Laurindo IMM, Kayser C. Sarcopenia in rheumatoid cachexia: Definition, mechanisms, clinical consequences and potential therapies. Rev Bras Reum. 2009;49, 294–30. [3]de Santana FS, da Cunha Nascimento D, de Freitas JPM, Miranda RF, Muniz LF, Neto LS, et al. Assessment of functional capacity in patients with rheumatoid arthritis: Implications for recommending exercise. Rev Bras Reumatol. 2014;54(5):378–85. Table 1. Associations between the quadriceps muscle morphology by ultrasound (pennation angle) with clinical features, muscle strength, functional capacity and physical function in rheumatoid arthritis patients. Variables n Components of the quadriceps muscle R p-value Age (y) 81 RF -0.290 0.009 VI NS NS VL -0.272 0.014 Disease duration (y) 81 RF NS NS VI NS NS VL NS NS Das-28 (CRP) 81 RF -0.415 &lt;0.0001 VI -0.304 0.006 VL -0.237 0.033 Handgrip strength test (kg) 81 RF 0.224 0.044 VI NS NS VL NS NS Chair stand test (s) 58 RF -0.372 0.004 VI -0.281 0.033 VL -0.290 0.027 HAQ (score) 65 RF -0.404 0.001 VI -0.302 0.015 VL NS NS TUG test (s) 68 RF NS NS VI NS NS VL NS NS SPPB (score) 58 RF 0.262 0.047 VI NS NS VL NS NS RF: rectus femoris; VI: vastus intermedius; VL: vastus lateralis; n: number; y: years; s: seconds; kg: kilogram; DAS28: Disease Activity Score 28; CRP: C-reactive protein; TUG: Timed-up-and-go; SPPB: Short Physical Performance Battery; NS: Not significant. Acknowledgements We thank the Coordination for the Improvement of Higher Level Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—CAPES) institution, the Foundation for Research Support of the Rio Grande do Sul State (Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul-FAPERGS), the Research and Events Incentive Fund (Fundo de Incentivo à Pesquisa e Eventos-FIPE) of HCPA and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico—CNPq). Disclosure of Interests None declared